| Objective:To explore the correlation between the six types of insulin resistance(IR)related indexes and the OSTA index in postmenopausal women,further investigate the relationship between IR and the risk of osteoporosis(OP)in postmenopausal women.Methods:A total of 574 postmenopausal women were enrolled from October 2018 to October 2019,aged 50-73 years old.Demographic data of each subjects were collected in detail.Height,weight,Waist circumference,hip circumference,systolic blood pressure(SBP),diastolic blood pressure(DBP)were measured,further to calculate body mass index(BMI),waist hip rate(WHR),testing biochemical indicators such as alanine aminotransferase(ALT),uric acid(UA),high-density lipoprotein(HDL-C),low-density lipoprotein(LDL-C),and triglycerides(TG).All subjects underwent oral glucose tolerance test(OGTT),and calculated 6 types of IR related indexes according to the blood glucose and insulin values tested by the OGTT test.All the subjects were divided into two groups according to the OSTA value,OSTA index>-1 was no risk of OP,and OSTA index≤-1 was at risk of OP.ANOVA test was applied to compare the difference of the two groups,Pearson correlation was used for correlation analysis,simple linear regression,multiple linear regression and logistic regression were used for regression analysis,and drawn receiver operating characteristic(ROC)curve.P <0.05 was considered statistically significant.Results1.574 postmenopausal women were divided into at risk of OP group(n=58)and no risk of OP group(n=516).Compared with at risk of OP group,the no risk of OP group had higher waistline(88.0±9.5 vs 81.4±8.4),hipline(101.5±7.6 vs 92.7±6.1),S%(91.48±35.29 vs 83.00±27.69),β%(116.07±40.33 vs 74.49±21.00),HOMA--β(137.82±81.42 vs 111.84±92.03),height(160.1±5.0vs 155.6±4.1),and lower HOMA-IR1(2.46±1.09 vs 2.84±1.37),SBP(121.21±16.44 vs 133.53±12.31),DBP(77.33±9.75 vs 83.52±6.88).The difference was statistically significant(P<0.05).2.OSTA index was positively correlated with height(r = 0.417),BMI(r =0.750),waistline(r = 0.491),hipline(r = 0.659),ALT(r = 0.087),UA(r = 0.100),S%(r = 0.151),β%(r = 0.486),FPG(r = 0.083),HOMA-β(r = 0.146)(P<0.05).The OSTA index was negatively correlated with HOMA-IR1(r =-0.519),ISI-Cederholm(r =-0.155),SBP(r =-0.196)(P<0.05).3.We used OSTA index as the dependent variable,S%,β%,HOMA-IR1,and HOMA-β as independent variables,gradually adjusting for different confounding factors.Model 1 did not adjust for any confounding factors,Model 2 adjusted height confounding factor,Model 3 adjusted for height,HDL-C,LDL-C,TG confounding factors.Compared the regression coefficients of four IR related indexes in the three models,S%(β1 = 0.009,β2 = 0.007,β3 = 0.008),β%(β1 = 0.026,β2 = 0.023,β3 = 0.022),HOMA-IR1(β1 =-0.175,β2 =-0.157,β3 =-0.175),HOMA-β(β1 = 0.004),Β2 = 0.004,β3 = 0.003),HOMA-IR1 had the largest regression coefficient in all three models.4.We used risk of OP as the dependent variable,HOMA-IR1 was used as the independent variable after the quartiles,and the lowest quartile was used as the reference,and different confounding factors were gradually adjusted,Model 1adjusted for height,Model 2 adjusted for waistline,hipline,Model 3 adjusted for height,waistline,hipline,HDL-C,LDL-C,TG,the results showed that all the three models had a P for trend of <0.05,suggesting that the risk of OP increased with the increased of IR.5.We used HOMA-IR1 as the detection variable,and the risk of OP as the outcome variable,the results showed that the area under the curve AUC(95%CI)was 0.614(0.535-0,693),P = 0.004.The best cut-off point was 2.464,with a sensitivity of 70.7% and a specificity of 57%.Conclusion: In postmenopausal women,HOMA-IR1,s%,β%,HOMA-β were all correlated with OSTA index,HOMA-IR1 had the strongest correlation with OSTAindex,after adjusting for confounding factors HOMA-IR1 was inversely related with OSTA index,the increased IR was associated with higher risk of OP,when the value of HOMA-IR1 exceeded 2.464,there was a risk of OP. |
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